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Zha Q, Xu Z, Yang H, Zhang G, Cai X, Zhang W, Liu Y, Shen X, Li Y. Development of a robot-assisted reduction and rehabilitation system for distal radius fractures. Front Bioeng Biotechnol 2024; 11:1342229. [PMID: 38268941 PMCID: PMC10805860 DOI: 10.3389/fbioe.2023.1342229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Closed reduction is the preferred treatment for distal radius fractures. However, it requires a multiple experienced medical staff and manually maintaining stable traction is difficult. Additionally, doctors cannot assess the reduction status of a fracture in real-time through radiographic images, which may lead to improper reduction. Furthermore, post-fracture complications such as joint adhesion, stiffness, and impaired mobility pose a challenge for the doctors. So it is necessary to optimize the treatment process of the distal radius fracture through technological means. Methods: A robot-assisted closed reduction and rehabilitation system, which could assist doctors throughout the entire process of reduction, fixation, and rehabilitation of distal radius fractures, was developed. A mechanical system, composed of two grippers and a cooperative robotic arm, was used to grasp and tract the affected limb. A doctor controlled the robot through a joystick console and Windows application program. A biplane radiographic device was integrated into the system, which is not only convenient for doctors to view radiographic images of the fracture at any time but also for them to select the rotation axis of the wrist on the images before reduction and rehabilitation. Important information including the anteroposterior and lateral radiographic data and force and position parameters during the reduction and rehabilitation process were displayed on a graphic user interface. Results: Experimental results showed that the proposed robotic system can meet the technical requirements for the reduction and rehabilitation of distal radius fractures, all the rotation angles could be achieved, a maximum force of more than 50 N could be achieved in all traction directions, and the error in selecting the wrist joint rotation axis line using radiographic images was less than 5 mm. Conclusion: The developed robot-assisted system was shown to be suitable for closed reduction and rehabilitation of distal radius fractures, contributing a potential improvement in the quality of the procedures.
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Affiliation(s)
- Qing Zha
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Zeou Xu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Hongbo Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Guodong Zhang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xuefeng Cai
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Wanlin Zhang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yujiang Liu
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xiaofeng Shen
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yuwei Li
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
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Bai L, Yang J, Chen X, Sun Y, Li X. Medical Robotics in Bone Fracture Reduction Surgery: A Review. SENSORS (BASEL, SWITZERLAND) 2019; 19:E3593. [PMID: 31426577 PMCID: PMC6720500 DOI: 10.3390/s19163593] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/12/2019] [Accepted: 08/12/2019] [Indexed: 11/17/2022]
Abstract
Since the advantages of precise operation and effective reduction of radiation, robots have become one of the best choices for solving the defects of traditional fracture reduction surgery. This paper focuses on the application of robots in fracture reduction surgery, design of the mechanism, navigation technology, robotic control, interaction technology, and the bone-robot connection technology. Through literature review, the problems in current fracture reduction robot and its future development are discussed.
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Affiliation(s)
- Long Bai
- State Key Laboratory of Mechanical Transmission, Chongqing University, Chongqing 400044, China.
| | - Jianxing Yang
- State Key Laboratory of Mechanical Transmission, Chongqing University, Chongqing 400044, China
| | - Xiaohong Chen
- State Key Laboratory of Mechanical Transmission, Chongqing University, Chongqing 400044, China
| | - Yuanxi Sun
- State Key Laboratory of Mechanical Transmission, Chongqing University, Chongqing 400044, China
| | - Xingyu Li
- State Key Laboratory of Mechanical Transmission, Chongqing University, Chongqing 400044, China
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Zhao JX, Li C, Ren H, Hao M, Zhang LC, Tang PF. Evolution and Current Applications of Robot-Assisted Fracture Reduction: A Comprehensive Review. Ann Biomed Eng 2019; 48:203-224. [DOI: 10.1007/s10439-019-02332-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/20/2019] [Indexed: 11/28/2022]
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Li C, Wang T, Hu L, Zhang L, Du H, Zhao L, Wang L, Tang P. A visual servo-based teleoperation robot system for closed diaphyseal fracture reduction. Proc Inst Mech Eng H 2015. [PMID: 26199026 DOI: 10.1177/0954411915595827] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Common fracture treatments include open reduction and intramedullary nailing technology. However, these methods have disadvantages such as intraoperative X-ray radiation, delayed union or nonunion and postoperative rotation. Robots provide a novel solution to the aforementioned problems while posing new challenges. Against this scientific background, we develop a visual servo-based teleoperation robot system. In this article, we present a robot system, analyze the visual servo-based control system in detail and develop path planning for fracture reduction, inverse kinematics, and output forces of the reduction mechanism. A series of experimental tests is conducted on a bone model and an animal bone. The experimental results demonstrate the feasibility of the robot system. The robot system uses preoperative computed tomography data to realize high precision and perform minimally invasive teleoperation for fracture reduction via the visual servo-based control system while protecting surgeons from radiation.
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Affiliation(s)
- Changsheng Li
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Tianmiao Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Lei Hu
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Lihai Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China
| | - Hailong Du
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China
| | - Lu Zhao
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Lifeng Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Peifu Tang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China
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Beretta E, De Momi E, Rodriguez y Baena F, Ferrigno G. Adaptive Hands-On Control for Reaching and Targeting Tasks in Surgery. INT J ADV ROBOT SYST 2015. [DOI: 10.5772/60130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Cooperatively controlled robotic assistants can be used in surgery for the repetitive execution of targeting/reaching tasks, which require smooth motions and accurate placement of a tool inside a working area. A variable damping controller, based on a priori knowledge of the location of the surgical site, is proposed to enhance the physical human-robot interaction experience. The performance of this and of typical constant damping controllers is comparatively assessed using a redundant light-weight robot. Results show that it combines the positive features of both null (acceleration capabilities > 0.8m/s2) and optimal (mean pointing error < 1.5mm) constant damping controllers, coupled with smooth and intuitive convergence to the target (direction changes reduced by 30%), which ensures that assisted tool trajectories feel natural to the user. An application scenario is proposed for brain cortex stimulation procedures, where the surgeon's intentions of motion are explicitly defined intra-operatively through an image-guided navigational system.
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Affiliation(s)
- Elisa Beretta
- Electronics, Information and Bioengineering Department, Politecnico di Milano, Milano, Italy
| | - Elena De Momi
- Electronics, Information and Bioengineering Department, Politecnico di Milano, Milano, Italy
| | | | - Giancarlo Ferrigno
- Electronics, Information and Bioengineering Department, Politecnico di Milano, Milano, Italy
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